Key result
Restrictive spirometry abnormalities were associated with significantly higher C-reactive protein concentrations compared to no pulmonary dysfunction before (P=0.006) and up to 6 days after CABG.
Why the study?
Are preoperative spirometry abnormalities associated with an intensified early inflammatory response in patients undergoing isolated CABG?
Observational (n=810)
Are preoperative spirometry abnormalities associated with an intensified early inflammatory response in patients undergoing isolated CABG?
Preoperative restrictive respiratory disorders are associated with an elevated generalized inflammatory response both before and after isolated CABG, suggesting a need for intensive postoperative respiratory monitoring and rehabilitation.
Hypothesis-generating for intensified monitoring in CABG patients with restrictive spirometry; prospective trials needed before adoption.
Background: Preoperative spirometry provides measurable information about the occurrence of respiratory disorders. The aim of this study was to assess the association between preoperative spirometry abnormalities and the intensification of early inflammatory responses in patients following coronary artery bypass graft in extracorporeal circulation. Material and methods: The study involved 810 patients (625 men and 185 women) aged 65.4±7.9 years who were awaiting isolated coronary artery bypass surgery. On the basis of spirometry performed on the day of admittance to the hospital, the patients were divided into three groups. Patients without respiratory problems constituted 78.8% of the entire group. Restricted breathing was revealed by spirometry in 14.9% and obstructive breathing in 6.3% of patients. Results: Inter-group analysis showed statistically significant differences in C-reactive protein (CRP) between patients with restrictive spirometry abnormalities and patients without any pulmonary dysfunction. CRP concentrations differed before surgery ( P =0.006) and on the second ( P <0.001), fourth ( P =0.005) and sixth days after surgery ( P =0.029). There was a negative correlation between CRP levels and FEV 1 . Conclusion: In our study, the most common pulmonary disorders in the coronary artery bypass graft patients were restrictive. Patients with abnormal spirometry results from restrictive respiratory disorders have an elevated level of generalized inflammatory response both before and after the isolated coronary artery bypass surgery. Therefore, this group of patients should be given special postoperative monitoring and, in particular, intensive respiratory rehabilitation immediately after reconstitution.
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Szylińska et al. (2017) conducted an observational in Patients awaiting isolated coronary artery bypass surgery (n=810). Preoperative spirometry abnormalities vs. Patients without pulmonary dysfunction was evaluated on C-reactive protein (CRP) concentrations (p=<0.001). Restrictive spirometry abnormalities were associated with significantly higher C-reactive protein concentrations compared to no pulmonary dysfunction before (P=0.006) and up to 6 days after CABG.
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